While numerous studies have examined the use of telemedicine within surgical subspecialties, there has yet to be a study that looks at surgical care from a broader perspective. A recent systematic review aimed to do just that by providing an evidence based overview of telemedicine in surgical care.
Traditional Surgical Care vs. Telemedicine
Telemedicine can be applied to surgical care in a variety of ways. Healthcare providers can use telehealth to conduct pre- and post-operative surgical consultations, administer remote monitoring, and provide surgical education. A December 2018 systematic review focused on these applications of telehealth and explored the broad use of telemedicine in surgical care.
The systematic review included 24 studies that used telemedicine during pre, peri, or post-surgical periods. All included studies compared traditional surgical care to care that was augmented with telemedicine. Of these studies, three were randomized controlled trials, three were pilot studies, four were retrospective studies that used data from medical records, and the remainder were observational studies.
The modes of telemedicine technology used in the studies primarily consisted of teleconferencing, mobile applications, digital images, and text messaging. Telemedicine was used for a variety of interventions, including, preoperative assessment, diagnosis, consultation with other surgical departments, post-operative wound assessment, or as a replacement for in-person follow-up.
The Benefits of Telemedicine in Surgical Care
The authors of the systematic review found that using telemedicine for preoperative assessment and diagnosis, and for evaluation and follow-up visits after surgery was beneficial to patients. The study aggregated results that demonstrated that patients who received telemedicine interventions were able to limit unnecessary trips to the hospital, save time, and reduce the number of work days they had to miss for medical reasons. As a result of these findings, the authors made the general conclusion that the use of telemedicine in surgical care provides benefits to both patients and providers.
Because the review included studies from a wide range of surgical specialties, the authors were able to report specific findings as well. Of the group of studies that examined telemedicine for pre-operative or diagnostic purposes, all reported 100% agreement between the telemedicine results and on-site results. The patient populations studied included vascular surgery patients, endocrine surgery patients, neurological surgery patients, and plastic surgery patients. Several of the individual studies reported that a telehealth pre-operative assessment was not only accurate, but also saved the patients a trip to the hospital and reduced complications during surgery.
Another group of studies focused on post-operative wound assessment. The clinicians in these studies examined wounds via either photographs or video conferencing. Based on the results of these studies, the authors concluded that telemedicine was able to improve post-operative follow up and limit the need for in-person wound checks, thus decreasing travel burden for patients.
The third group of studies looked at using telemedicine for standard post-surgical follow-up. The findings from these studies demonstrated that telemedicine facilitated improved communication, while allowing for reliable follow-up assessments. Additionally, the authors found that telemedicine was associated with improved medication adherence, lower systolic blood pressure, and faster adjustment to medications.
Improving the Patient Experience
In addition to exploring clinical outcomes among various groups of surgical patients, the authors also examined patient satisfaction and money saved. One study evaluated patients who had undergone urological procedures and found that more than 95% of patients in the telemedicine group reported that their care was good. These patients also felt that telemedicine should be an option for patient care in the future. All of the remaining studies in the systematic review that included a patient satisfaction component reported high satisfaction as well.
Two of the studies in the review touched on money saved. The studies reported patients’ comments that they saved money as a result of limiting unnecessary trips to the hospital, using their time more efficiently, and reducing the number of work days missed.
The Future of Surgical Care
As a result of the broad range of studies included in the systematic review, the authors were able to make a generalized conclusion that the use of telemedicine in preoperative assessment and diagnosis, post-surgical evaluation, and follow-up visits after surgery was beneficial. They even went so far as to point out that telemedicine has advantages over traditional surgical care because it can limit travel burdens on patients and reduce medical complications related to surgery.
Based on these findings, the authors suggest that healthcare providers consider implementing telehealth in hospitals to improve the efficiency of care, expand healthcare access to more patients, and decrease hospital readmissions. Additionally, the authors promote the use of telemedicine as a collaboration tool between surgical teams at different locations.
Overall, the systematic review demonstrates that telemedicine in surgical care is beneficial to both patients and providers. As providers embrace the use of this technology, we are sure to see rapid advancements in patient care and surgical outcomes.
Asiri A, AlBishi S, AlMadani W, et al. The Use of Telemedicine in Surgical Care: a Systematic Review. Acta Inform Med. 2018 Oct;26(3):201-206.